Programa de controle do tabagismo no município de Juiz de Fora: a especificidade do tratamento na atenção básica

Abstract

This dissertation is about the Municipal Tobacco Control Program (MTCP), in the city of Juiz de Fora, emphasizing, among other actions of the Program, the offering of tabagism treatment in the basic services from the public health system care (Sistema Único de Saúde - SUS). This paper approaches the whole dynamic involving the tabagism issue, in all its different aspects: social, economical, environmental and public health. It presents the fighting and controlling tabagism measures world wide, focusing on the Brazilian tabagism Control Program, its organization, results and decentralization strategy in order to involve states and cities. The methodology used was based on the qualitative approach and a field research was made with ten managers of different hierarchical levels from the Juiz de Fora Secretary of Health. Facing the lack of support from the Primary Unit Health Care (Unidades de Atenção Primária à Saúde – UAPS) to offer the tabagism treatment, the research identified, by the point of view of the managers, a gathering of factors that interfere with the development of the Program, there for on interfering with the treatment offers. The results of this study show that a bigger commitment from the Secretary of Health is required regarding this Program, this is due to the fact that the former doesn‟t have its own founding, reflects on the behavior of the managers regarding any program, including this one, leading to a non- officialization of it and demanding initiatives from the others UAPS that don‟t support the treatment offering. The rotativity of the staff, including the managers, and the type of contract also appears as a drawback, making more difficult the support and the continuity of the treatment. The organization of the National Program reflects on the development of the tabagism control Policy in the states and cities. There is a lack of interaction between the different coordination levels, means of the communication, an accurate evaluation system and financing the program. The realization of this paper lead to a reflection about the Tabagism Program in both levels, national and local, from the results presented some suggestions are given in order to assure the continuity of the program and its accesses for all the population.